METHOD OF INTRA-SINUS SUPERAXILLARY ELIMINATION OF MAXILLARY SINUS UPPER WALL DEFECTS Russian patent published in 2020 - IPC A61B17/00 A61F9/07 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to maxillofacial surgery. Performing spiral computed tomography of upper jaw and eye socket. Results of the tomography are used to determine the shape and size of an eye socket defect. Magnitude and degree of prolapse of peripheral tissues into maxillary sinus, size and shape of maxillary sinus are evaluated. Surgical approach is performed through oral vestibule. Under general or local conductive anesthesia, a mucous membrane is incised in advance of the oral cavity above the mucous-gingival line by 1 cm within the canine, premolars and the first molar. Then the maxillary sinus front wall is skeletonized, creating an overview of the lower edge of the orbit and the place of the infraorbital nerve exit. Milling cut is performed in the upper part of the anterior wall of the maxillary sinus, laterally, than the infraorbital orifice. With endoscopic support, the natural junction of the maxillary sinus is expanded in the middle nasal passage of the nasal cavity. Through the expanded fistula a silicone cylinder is introduced into the maxillary sinus lumen. Schneider membrane is peeled off from upper and upper walls of maxillary sinus. Tunnel is formed, which is intended for insertion of the implant, which eliminates the defect of the upper wall of the maxillary sinus, in the case of periocular peritoneal prolapse into the sinus lumen, it is inserted into the orbital cavity. Implant of biodegradable material with thickness of 1 mm is introduced into formed tunnel, larger than defect by 2 mm along perimeter, and fixed by fibrin glue to edges of defect. Silicone cylinder is inflated in the maxillary sinus lumen, thus leading to Schneider membrane expansion. Wounds are closed on mucous membrane. Silicone cylinder is removed from the sine on the fifth day after confirming the membrane spreading. Sutures are removed on 10th day.

EFFECT: method enables one-stage surgical intervention with minimal traumatism, avoiding incisions on the face, eliminating bone defects of the upper wall of the maxillary sinus without contact of the implanted structures with the contents of the maxillary sinus, avoiding the presence of structures in the remote postoperative period.

1 cl, 1 ex